Non-transecting anastomotic urethroplasty for strictures of the bulbar urethra. Systematic review

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Abstract

The results of using non-transecting anastomotic urethroplasty in men with bulbous urethral strictures are presented in the review. A total of 25 original publications were found, including 20 foreign and 5 Russian articles. The studies included from 1 to 358 patients who underwent anastomotic urethroplasty without transection of the corpus spongiosum (average number of patients in a study was 54). Etiological factors were indicated in 17 articles. Most studies (10 out of 17) indicated idiopathic etiology as the predominant one. There was no correlation between the results of the procedure and the etiology of urethral stricture. The mean length of urethral stricture in the vast majority of studies was less than 2 cm, and only in a few studies it was larger, with a maximum mean value of 3.9 cm. Postoperative complication rates were reported in 20 studies and ranged from 0% to 23.9% within one study (median 8.4%). In general, mild complications occurred, corresponding to category I–II according to the Clavien-Dindo classification. The incidence of erectile dysfunction was evaluated in 18 studies and ranged from 0% to 23% (average value of 6.5%). The success of non-transecting anastomotic urethroplasty averaged 94.7% (82–100%) with a median postoperative follow-up of 24.5 months (3–150 months). In 9 out of 25 studies, an additional comparison with transecting technique was done. In 6 studies, the superiority of the non-transecting technique in terms of treatment success and preservation of sexual function was found. The obtained results showed the high efficiency and safety of non-transecting anastomotic urethroplasty in case of short strictures of the bulbous urethra.

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About the authors

M. I. Katibov

GBU of the Republic of Dagestan «City Clinical Hospital»

Author for correspondence.
Email: mikatibov@mail.ru

Ph.D., MD, associate professor, Chief of the Urologic Department of GBU of the Republic of Dagestan «City Clinical Hospital»

Russian Federation, Makhachkala

A. B. Bogdanov

S.P. Botkin’s State Clinical Hospital; Russian Medical Academy of Continuous Professional Education (RMACPE)

Email: abbogdanov@hotmail.com

Ph.D., urologist at the Department of Urology of S.P. Botkin’s State Clinical Hospital, associate professor at the Department of Urology and Surgical Andrology of Russian Medical Academy of Continuous Professional Education (RMACPE)

Russian Federation, Moscow; Moscow

E. I. Veliev

S.P. Botkin’s State Clinical Hospital; Russian Medical Academy of Continuous Professional Education (RMACPE)

Email: veliev@urotop.ru

Ph.D., MD, professor, professor at the Department of Urology and Surgical Andrology of Russian Medical Academy of Continuous Professional Education (RMACPE), Head of the Department of Urology of S.P. Botkin’s State Clinical Hospital

Russian Federation, Moscow; Moscow

O. B. Loran

Russian Medical Academy of Continuous Professional Education (RMACPE)

Email: oleg_loran@gmail.com

Academician of RAS, Ph.D., MD, professor, Head of the Department of Urology and Surgical Andrology of Russian Medical Academy of Continuous Professional Education (RMACPE)

Russian Federation, Moscow

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